Diagnostic Accuracy, Reliability And Validity Of Childhood Autism Rating Scale In India
Paul Ss Russell, Anna Daniel, Sushila Russell, Priya E. Mammen, Julie Sandra Abel, Lydia Edward Raj, Satya Raj Shankar, Naveen M. Thomas
Published 2010 · Medicine
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BackgroundSince there is no established measure for autism in India, we evaluated the diagnostic accuracy, reliability and validity of Childhood Autism Rating Scale (CARS).MethodsChildren and adolescents suspected of having autism were identified from the unit’s database. Scale and item level scores of CARS were collected and analyzed. Sensitivity, specificity, likelihood ratios and predictive values for various CARS cut-off scores were calculated. Test-retest reliability and inter-rater reliability of CARS were examined. The dichotomized CARS score was correlated with the ICD-10 clinical diagnosis of autism to establish the criterion validity of CARS as a measure of autism. Convergent and divergent validity was calculated. The factor structure of CARS was demonstrated by principal components analysis.ResultsA CARS score of ≥33 (sensitivity = 81.4%, specificity = 78.6%; area under the curve = 81%) was suggested for diagnostic use in Indian populations. The inter-rater reliability (ICC=0.74) and test-retest reliability (ICC=0.81) for CARS were good. Besides the adequate face and content validity, CARS demonstrated good internal consistency (Cronbach’s α=0.79) and item-total correlation. There was moderate convergent validity with Binet-Kamat Test of Intelligence or Gessell’s Developmental Schedule (r=0.42; P=0.01), divergent validity (r=−0.18; P=0.4) with ADD-H Comprehensive Teacher Rating Scale, and high concordance rate with the reference standard, ICD-10 diagnosis (82.52%; Cohen’s κ=0.40, P=0.001) in classifying autism. A 5-factor structure explained 65.34% of variance.ConclusionThe CARS has strong psychometric properties and is now available for clinical and research work in India.
This paper references
ACTeRS useful in screening learning disabled from attention deficit disordered (ADD-H) children.
Ullmann Rk (1985)
Reliability and validity of the Childhood Autism Rating Scale-Tokyo version (CARS-TV)
H. Kurita (1989)
Field trial for autistic disorder in DSM-IV.
F. Volkmar (1994)
Validity and reliability of the Childhood Autism Rating Scale with autistic adolescents
Deborah G. Garfin (1988)
Evidence-Based Assessment of Autism Spectrum Disorders in Children and Adolescents
S. Ozonoff (2005)
Prevention of thalassemia in India.
Naveen Thacker (2007)
At the Threshold: The Developing Adolescent
F. Volkmar (1994)
Quantifying dimensions in autism: a factor-analytic study.
P. Szatmari (2002)
Use of the childhood autism rating scale with autistic adolescents and adults.
G. Mesibov (1989)
Factor Structure Evaluation of the Childhood Autism Rating Scale
C. Magyar (2007)
Indian pediatrics and child survival [editorial]
Purujit Choudhury (2007)
Autism Diagnostic Interview-Revised and the Childhood Autism Rating Scale: Convergence and Discrepancy in Diagnosing Autism
E. Saemundsen (2003)
Integrated management of neonatal and childhood illnesses: a new hope for child survival.
Naveen Thacker (2007)
The Swedish Version of the Childhood Autism Rating Scale in a Clinical Setting
V. Nordin (1998)
Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) Correspondence and Conflicts with DSM-IV Criteria in Diagnosis of Autism
E. Rellini (2004)
Measuring intelligence of Indian children
Venkatrao Vithal Kamat (1968)
Autism -- experiences in a tertiary care hospital.
Veena Kalra (2005)
Domains of the childhood autism rating scale: Relevance for diagnosis and treatment
David L. DiLalla (1994)
Childhood autism rating scale--Tokyo version for screening pervasive developmental disorders.
Hisateru Tachimori (2003)
The first five years of life, the preschool years.
Arnold Gesell (1940)
Social and Nonsocial Factors in the Childhood Autism Rating Scale
J. Stella (1999)
Brief report: Analysis of the internal consistency of three autism scales
P. Sturmey (1992)
Newborn and childhood screening programmes: criteria, evidence, and current policy
D. Elliman (2002)
The epidemiology of autistic spectrum disorders: is the prevalence rising?
L. Wing (2002)
Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. The Standards for Reporting of Diagnostic Accuracy Group.
P. Bossuyt (2003)
Toward objective classification of childhood autism: Childhood Autism Rating Scale (CARS)
E. Schopler (1980)
Validation of screening procedures.
A. Cochrane (1971)
Screening and surveillance for autism and pervasive developmental disorders
G. Baird (2001)
AN ITEM SELECTION PROCEDURE TO MAXIMISE SCALE RELIABILITY AND VALIDITY
J. Raubenheimer (2004)
Is there an increase in the prevalence of autism spectrum disorders?
M. Prior (2003)
Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative
P. Bossuyt (2003)
A comparison and evaluation of three commonly used autism scales
J. Sevin (1991)
The criterion-related validity of the Childhood Autism Rating Scale and the Autism Behavior checklist
R. Eaves (1993)
Multi-site Study of the Childhood Autism Rating Scale (CARS) in Five Clinical Groups of Young Children
A. Perry (2005)
Changing criteria of autistic disorders: A comparison of the ICD-10 research criteria and DSM-IV with DSM-III-R, CARS, and ABC
E. Sponheim (1996)
Current topic: Screening and surveillance for autism and pervasive developmental disorders.
G. Baird (2001)
This paper is referenced by
Sensory Profile Caregiver Questionnaire: A Measure for Sensory Impairment Among Children with Developmental Disabilities in India
Tanya Elizabeth Benjamin (2014)
Systematic review of tools to measure outcomes for young children with autism spectrum disorder.
Helen McConachie (2015)
Autismus-Spektrum-Störungen im Kindes-, Jugend- und Erwachsenenalter
Kai Vogeley (2018)
Validity and reliability of the Thai version of the Autism Treatment Evaluation Checklist: A two-phase diagnostic accuracy study
Kanitha Sunakarach (2018)
Consensus statement of the Indian academy of pediatrics on evaluation and management of autism spectrum disorder
Samir H Dalwai (2017)
Correlation patterns between pretend play and playfulness in children with autism spectrum disorder, developmental delay, and typical development
Ya Chen Lee (2016)
Priority Mental Health Disorders of Children and Adolescents in Primary-care Pediatric Setting in India 1: Developing a Child and Adolescent Mental Health Policy, Program, and Service Model
Paul Ss Russell (2011)
Autism Behavior Checklist for Disability Estimation: A Preliminary Field Tryout
Srinivasan Venkatesan (2015)
CDC Kerala 10: Diagnostic Accuracy of the Severity Scores for Childhood Autism Rating Scale in India
M. K. C. Nair (2014)
Comedy Movies and Stock Returns of Locally Headquartered Companies: Evidence from China
Jing Lu (2019)
Autism Spectrum Disorder: The Dilemma of Untimely Recognition, Intervention and Diagnostic Scales Obtainable at Indian Sub-conti- nent
C. S. Kanimozhiselvi (2019)
Brief Parent-Mediated Intervention for Children with Autism Spectrum Disorder: A Feasibility Study from South India
Harshini Manohar (2019)
Diagnostic tests for autism spectrum disorder (ASD) in preschool children.
Melinda Randall (2018)
Gr upSM Autism Spectrum Disorder-An Indian Perspective
Monica Juneja (2018)
Use of Indian Scale for Assessment of Autism in Child Guidance Clinic: An Experience
Suravi Patra (2011)
Autism Interventions in India: a Systematic Review
Sarah Dababnah (2018)
Validation of the lebanese childhood autism rating scale-second edition-standard version
Leyla Akoury-Dirani (2013)
Kuan-Lin Chen (2019)
Culturally adapted pictorial screening tool for autism spectrum disorder: A new approach
H. Perera (2017)
A Pilot Feasibility Study of Neurofeedback for Children with Autism
Naomi J. Steiner (2014)
The utility of the Gilliam autism rating scale for identifying Iranian children with autism
Sayyed Ali Samadi (2014)
Updated report on tools to measure outcomes of clinical trials in fragile X syndrome
Dejan B. Budimirovic (2017)
Can questions about social interaction correctly identify preschool aged children with autism?
Katrina Williams (2013)
Prediction Of Playfulness By Pretend Play, Severity Of Autism Behaviors, And Verbal Comprehension In Children With Autism Spectrum Disorder
Kuan-Lin Chen (2019)
Diagnostic accuracy of Indian Scale for Assessment of Autism (ISAA) in chidren aged 2–9 years
Sharmila B Mukherjee (2015)
Effectiveness of Exergame on Executive Function of Autistic Children
M Suamthi (2017)
Feeding Problems Among Children with Autism in a Clinical Population in India
Jewel Elias Crasta (2014)
Machine Learning based Autism Grading for Clinical Decision Making
Understanding the Psycho-Physiological Implications of Interaction With a Virtual Reality-Based System in Adolescents With Autism: A Feasibility Study
Selvia Kuriakose (2015)
A Study to Measure The Effectiveness of Differential Reinforcement for Stereotypical Behavior in Autism Spectrum Disorder
K. M. Mariam Minazir (2016)
A case report of the dental management of a patient with Sotos syndrome
Shaik Mohammed Asif (2011)
Autism Spectrum Disorder: 70 Years on and the Plot Thickens
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